Obamacare enrollment push for the young enters 11th hour

WASHINGTON, Feb 14 (Reuters) - One of the latest Obamacarepitches to get young adults to sign up for health insurancestarts out with a mother's kitchen note reminding her grown sonto enroll.

"Mom, you know I can't afford it," the young black manprotests, as he sits down at a kitchen table next to abespectacled woman with a laptop computer linked to the U.S.federal enrollment website, HealthCare.gov.

"But for the first time you can," she replies reassuringly."You go to the HealthCare.gov website, compare quality plans andyou could get help paying for it."

The government-sponsored television ad, which is airing onfive national cable-TV channels, including ABC Family andTVLand, is part of an uphill battle to increase youthparticipation in President Barack Obama's signature domesticpolicy achievement. Youth participation in the program is a keyfactor in whether the program succeeds or fails in its firstyear.

U.S. government data released this week show the demographicof adults aged 18-34 rose only slightly by the end of January to25 percent of total enrollment in private Obamacare plans.

That is well below the 38 percent that administrationofficials have talked about achieving to give insurers a strongmix of healthier members, whose premium payments help offset thecost of older, sicker policyholders.

Several top insurers have expressed unease about the mix ofenrollment so far, and Republican opponents of the law see weakyouth participation as the start of a downward spiral that willput the government on the hook for more spending to keep italive.

The Obamacare marketing push has already been delayedrepeatedly by the botched rollout of HealthCare.gov in October,requiring the administration to focus its efforts on fixing thewebsite. Given those delays, experts say the Obamacaremarketplaces could have trouble getting much above the 30percent mark by the time enrollment ends on March 31.

Obamacare's advocates from the White House to federal andstate agencies, health insurers, hospitals and grassrootsnonprofit groups are launching the final push on Saturday, withwhat they call National Youth Enrollment Day.

"We're entering the sprint to the end," said Aaron Smith,executive director of Young Invincibles, a nonprofit group thatis spearheading youth outreach.

The Centers for Medicare and Medicaid Services, the federalgovernment's lead Obamacare agency, allocated $52 million forpaid media in the first three months of 2014.

The campaign has already had help from singers Lady Gaga andJohn Legend and actress Olivia Wilde. Focus is now on sportscelebrities including former professional basketball star MagicJohnson, who appears in a promotion alongside this week'sOlympic Games. CMS will also run ads during the hugely popularcollege basketball playoffs known as March Madness.

Administration officials say young adults are only oneaudience for the effort. But the campaign is targeting 25 U.S.metropolitan areas that are home to 5 million uninsured youngadults, according to a Reuters analysis of U.S. Census data.

"There's a variety of tactics," said Marlon Marshall, deputydirector of the White House Office of Public Engagement. "All ofthose things add up to one big echo chamber. And that echochamber is going to grow."

Health insurers are expected to fork out millions more toadvertise their plans. Nonprofit groups Enroll America and thenonpartisan Ad Council have a $30 million TV campaign withsinging pets.

The campaign competes with counter-messaging fromRepublicans and other Obamacare critics including GenerationOpportunity. The young conservatives group sought to discourageenrollment last year with viral online videos picturing youngmen and women cornered in intimate medical settings by a creepyUncle Sam puppet. The group says it is planning "a barrage ofefforts," which it declined to detail.

CONCERN OVER PRICE HIKE

Obama's Patient Protection and Affordable Care Act barredlongstanding insurance market practices that imposed sharplyhigher prices on people who were sick or older. That puts theonus on the program to spread insurers' risks betweenpolicyholders who need lots of medical attention and youngerconsumers who tend to be healthy and cheaper to insure.

The concern is that the fewer young adults sign up, thehigher insurance costs may have to rise for 2015.

A Massachusetts health insurance marketplace, launched in2007 under former Republican Governor Mitt Romney and widelyseen as the prototype for the Obamacare exchanges, took ninemonths to breach the 30 percent mark, according to an analysisby Jonathan Gruber, an MIT professor and an architect ofObamacare and Massachusetts' earlier reforms.

Gruber and other experts say reaching about 30 percentparticipation is a more reasonable goal for Obamacare in 2015than 2014 given its challenges, including bitter partisanopposition, scant funding, and a public that is largelymisinformed about the law and the botched HealthCare.gov launch.